The morning news. [volume] (Savannah, Ga.) 1887-1900, 1887-09-29
SWALLOWED A TOOTH.
Something That Puzzled the New
York Surgeons.
From The Cincinnati Enquirer.


may stumble upon something that will sur
prise him in ordinary cases which appear
simple and easily explainable. An exhibition
of this was given last week in the case of
Mary Holske, a middle-aged woman, who
was brought to the New York Hospital
about two weeks ago. The patient had been
i'll about two months before her admission to
the hospital The origin OF her trouble was
a fall, or at least that is what the woman
believed While walking i'll the dark she
| tripped fell and her neck struck violently
upon a chair The flesh in her neck turned
black from the blow, and was sore and pain
full. She had some difficulty in swallowing
after the injury.
| About week afterward, while drinking,
she suddenly choked and coughed as people
do when a foreign body passes into the
windpipe. The spasmodic contraction of
the throat was so great that the woman
nearly died from suffocatlon, but nature
finally brought relief without any other
artificial assistance than a severe pounding
on the back
The woman was never well after this.
There was always an annoying
PAIN IN HER THROAT.
She described the feeling as resembling a
boring machine at work In her neck. A
heavy weight seemed to be pressing upon
her head, and as usual, when this feeling Is
present, the woman's mental condition was
unbalanced, and she was possessed of the
most frightful delusions. She had an idea
that her feet were useless; that when NOV
ing around she walked on her hands, and
when she was quiet she stood on her head.
This, to her mind, was the cause of the
pressure on her neck,
Her ailment was at first thought to be due
to the introduction of some foreign body in
the larynx. The symptoms and spasms that
she had endured were believed to result from
this cause The laryngoscope was called into
play, and a careful examination was made
of the larynx, without, however, giving
any explanation of the difficulty. A slight
swelling appeared in the neck just above
the breast bone The pain increased and
there were frequent spasms Solid food
could not be swallowed at all, and liquid
food was not an easy thing to take. The
pain seemed to dart from the neck to the
middle of the back. Her skin took on the
yellow hue that is common to patients with
iaundice, though the liver was not at all af-
fected. When food was given it was always
followed by great prostration. The woman,
who was stout and weighed nearly 200
pounds, lost flesh SO rapidly that it could
almost be seen to leave her bones, She was
reduced to a skeleton and her strength was
gone entirely. Paroxysms came on fire.
quently, during which she would utter cries
LIKE A WILD ANIMAL
She was taken to the hospital when there
was no hope of life, being delirious and en-
tirelv unconscious of her surroundings. DIR.
Rice, to whom she was assigned, looked
upon her as little better than a dead
woman. He studied her history carefully,
and came to the conclusion that she was
suffering from a carcinoma, or cancer of
the oesophagus. She was in such reduced
state tlSlt it was not thought possible to do
anything for her. She was put into a cot
with the same idea that an old horse is
turned out to grass-that is, to die. Bnt
she did not die, and after several days her
vitality seemed to improve slightly, and an
operation was decided upon, the object of
which was to remove a portion of the pso-
phagus in the hope of prolonging the
woman's life, although, taking her condi-
ton into consideration. it were better that
she were dead.
She was taken to the operating ROOM
Only small quantity of ether was given,
as the woman was unconscious, and the only
object in giving the anaeSthetic was to re-
duce the shock. An incision was made in
the right side of the neck about five inches
long. The head of the patient was drawn
backward so as to make the muscles In the
throat prominent. The sterno mastoid
muscle was taken as a guide and the in
cision was made in the depression between
the larynx and this muscle The flesh was
divided with the utmost caution in order to
avoid the large blood-vesSels in the neck
any laceration of which might prove almost
instantaneousy fatal. The sheath of the
carotid was found to be somewhat out of the
usual position A retractor was placed
under the sheath, and it and the sterno mas
told were drawn backward. The larynx
was pulled in the opposite direction with
retractor to open the wound. A slender in
strument was passed into the mouth and in
troduced into the psophagus and pressed
outward so as to indicate the true position
The flesh around it being cautiously re-
moved.
THE QSoPHAGUS WAS EXPOSED
at considerable length. But there was no
sign of disease in the upper portion Of it
where canoe s are usually found The in
cision was extended downward, and every
hairs breadth that the knife descended was
examined in order that there might be no
slip. All the large arteries were avoided
with great skill. Before the breast bone
was reached the oesophagls and neighboring
tissue wasfound to be infiamed By carry
ing the incison little below the bone it
was discovered that a hole had been
eaten through the psophagus by ulcera-
ton. There were no signs of cancerous
infiltration in the tissue, and the ulcer evil
IDENTIFY was not malignant II extended
in the tissue downward and backward
and left small passage in it, as if an arti-
ficial duct had been made. The surgeon
having an exceedingly small hand was able
to pass his finger through this passage at
considerable length, ard was astonished to
find hard substance. 1t was lodged in the
cavity of the pericardium and pressed
against the breast. A small forceps with
curved lower section and serrated edge was
gently passed into the cavity. After many
failures the substance was caught firmly
and drawn out The surgeon was astounded
to find
A LARGE FALSE TOOTH
attached to broken piece of plate The
tooth had been swallowed unknown to the
patient, had lodged in the oesophagus and
liberated into the percardun, and thus had
caused her agony, and not the fall, as was
supposed.
Fortunately the removal of the tooth set
up only slight hemorrhage, and the blood
was quickly absorbed by sponges As much
of the liberated surface as was visible was
sprayed with carbolic acid solutions, and
the wound in the neck was closed. Only q
few sutures were used.
The operation as a demonstration of the
surgeons art was eminently successful, but
whether it will be of any benefit to the pa
tlent is yet in doubt. The attendant shock
was not SO great as was anticipated and the
patient shows wonderful recuperative
power, but pericarditis set in, and this
usually means death She is still alive and
= fal,. a.